Stroke Recovery Got More Complicated

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I thought recovering from my strokes was going to be the biggest physical challenge of my life.

I was wrong.

Stroke recovery was hard enough. Learning to use my body again, trying to get more movement back in my hand and arm, working on balance, strength, and everyday activities—it all takes work.

A lot of work.

And just when I was trying to figure out how much exercise and repetition my body could handle, other problems entered the picture.

Now, in addition to recovering from my strokes, I am dealing with myasthenia gravis, a new hip, a bad knee, and diastasis recti.

None of these things have made rehabilitation easier.

In fact, each one can affect the exercises I do in occupational therapy and physical therapy.

First, There Were the Strokes

A stroke happens when blood flow to part of the brain is interrupted or reduced, damaging brain cells. Depending on where the stroke occurs, it can affect movement, speech, balance, thinking, vision, and many other functions.

In my case, one of the biggest challenges has been regaining the use of my affected hand and arm.

Stroke recovery often involves repetition. The brain has to be given opportunities to relearn movements and develop new pathways through neuroplasticity.

That means exercises.

Practice.

Repetition.

And more repetition.

But what happens when the rest of your body starts giving you additional problems?

That’s where my story got more complicated.

Then Came Myasthenia Gravis

Myasthenia gravis, usually called MG, is a neurological autoimmune disease that affects communication between nerves and muscles. One of its main characteristics is muscle weakness that can worsen with activity and improve with rest.

That creates an interesting problem when you are also trying to recover from a stroke.

Stroke rehabilitation often encourages repetition and consistent practice. But MG can mean that doing too much can leave you fatigued and weaker.

So, I have to pay attention.

There may be days when I can do more and days when I have to back off.

I may need to break exercises into shorter sessions instead of trying to do everything at once.

That doesn’t mean I am quitting or losing my motivation.

It means I have other factors to consider.

A New Hip

Then there is my new hip.

A hip replacement involves replacing a damaged hip joint with an artificial joint. While the goal is usually to reduce pain and improve mobility, recovering from the surgery takes time and rehabilitation.

The hip plays a major role in almost everything involving movement.

Walking.

Standing.

Getting out of a chair.

Balance.

Turning.

Weight shifting.

Many of those things are already part of stroke rehabilitation.

Now I have to consider my hip while doing them.

Sometimes the stroke may not be the thing limiting an exercise. Sometimes it may be the hip.

The Bad Knee

My knee has also decided it wants to be part of the story.

A bad knee can affect walking, standing, balance, and almost every lower-body exercise. Pain or weakness in the knee can make it harder to do exercises that would otherwise help with stroke recovery.

Again, everything is connected.

If the knee hurts, walking may be affected.

If walking is affected, balance exercises may be affected.

If balance is affected, other parts of physical therapy may have to be adjusted.

The body doesn’t seem to care that I already have enough going on.

And Then There Is Diastasis Recti

Diastasis recti is a separation of the abdominal muscles along the midline of the stomach. It can affect core stability and how the abdominal muscles support the body.

Your core is involved in much more than having strong abdominal muscles.

It helps with posture.

Balance.

Standing.

Walking.

Moving from one position to another.

For someone recovering from a stroke, core strength and stability are already important. Diastasis recti adds another consideration because some traditional abdominal exercises may not be appropriate.

So once again, exercises may need to be modified.

Are you starting to see a pattern here?

Everything Affects Everything Else

This is something I have learned during this journey.

My occupational therapist may be focused on my hand and arm.

My physical therapist may be focused on walking, balance, and mobility.

But my MG can affect my endurance.

My hip can affect my walking.

My knee can affect my balance.

My diastasis recti can affect my core stability.

And all of them can affect how much exercise I can safely do.

There is no longer a simple exercise plan where I can just say, “Do this many repetitions and everything will be fine.”

Every day may be different.

Some days I may be able to do more.

Other days I may have to do less.

And sometimes I may have to change an exercise completely.

That Doesn’t Mean I Stop

I want to be clear about something.

I am not giving up on my stroke recovery.

I still believe in exercise.

I still believe in repetition.

I still believe that the brain and body can continue to learn.

But I also have to be realistic.

I can’t pretend that myasthenia gravis, a new hip, a bad knee, and diastasis recti don’t exist.

Ignoring them would not make me tougher.

It would just be foolish.

So my rehabilitation may have to change.

Instead of doing one long exercise session, I may do several shorter ones.

Instead of standing for an exercise, I may do it sitting down.

Instead of doing a certain number of repetitions, I may have to stop when fatigue or pain tells me it is time to stop.

Instead of following the exact same routine every day, I may have to adjust according to what my body can handle that day.

I Will Adjust, Not Quit

This is the part of my recovery journey I am still learning.

I don’t have to choose between pushing through everything and doing nothing.

There is a middle ground.

I can continue working toward recovery while respecting the other problems my body is dealing with.

My OT and PT exercises may have to change.

The number of repetitions may change.

The length of my exercise sessions may change.

The way I perform certain exercises may change.

But the goal remains the same.

To keep improving wherever improvement is possible.

I don’t know exactly what the future will look like. I don’t know how each of these conditions will affect my recovery over time.

What I do know is that giving up isn’t part of my plan.

That doesn’t mean I am going to pretend to be tougher than I am or ignore what my body is telling me.

It means I will adapt.

I will work with my doctors and therapists.

I will adjust my exercises when necessary.

I will rest when I need to.

And I will continue to look for safe ways to challenge my brain and body.

My rehabilitation journey just became more complicated.

But complicated isn’t the same thing as impossible.

I have already learned that recovery rarely goes exactly as planned.

So I will keep doing what I can, when I can, and adjust when I have to.

And there is something else I would say to other stroke survivors.

Keep doing those exercises.

Keep working on your recovery.

Keep giving your brain and body the opportunity to improve.

Because you never know what other factors might come along and get in the way of your progress.

None of us knows what health problems, injuries, or other challenges may be waiting down the road. The progress you make today may become even more important if something else later makes your rehabilitation more difficult.

So do what you can now.

Make the most of the opportunities you have now.

I may have more obstacles now than I did when this journey started.

But I’m still on the journey.

And I’m not done yet.